eMedinewS6th September 2013, Friday

Dr K K Aggarwal Padma Shri and Dr B C Roy National Awardee

Dr KK Aggarwal

President, Heart Care Foundation of India; Sr Consultant Physician, Cardiologist & Dean Medical Education Moolchand Medcity; Editor in Chief IJCP Group, National Vice President Elect, Indian Medical Association; Hony. Visiting Professor (Clinical Research) DIPSAR; Chairman (Delhi Chapter) International Medical Sciences Academy (March 10–13); Hony Director IMA AKN Sinha Institute (08–09); Hony Finance Secretary National IMA (07–08); Chairman IMA Academy of Medical Specialties (06–07); President Delhi Medical Association (05–06), President IMA New Delhi Branch (94–95, 02 –04);
For updates follow at
www.facebook.com/Dr KKAggarwal

CRT may harm patients of moderate-to-severe heart failure with short QRS duration

  • Cardiac resynchronization therapy might harm patients with moderate–to–severe heart failure who have a short QRS duration. The rate of all–cause death or a first hospitalization for heart failure was 28.7% with CRT turned on and 25.2% with CRT turned off, a nonsignificant difference according to Johannes Holzmeister, MD, of University Hospital Zurich. But the rate of all–cause death on its own was significantly higher in the CRT group (11.1% versus 6.4%). The study is published in New England Journal of Medicine.
  • A new biomarker analysis may give doctors in the emergency department the ability to safely tell chest pain patients: "You are not having a heart attack. You can go home." Patients who were troponin negative and also copeptin negative, using the initial blood sample, had virtually the same risk of having a major adverse cardiac event within 30 days –– 5.46% –– as patients undergoing the usual battery of examinations to rule out myocardial infarction (5.50% at 30 days (P=0.04 for noninferiority)), reported Martin Mockel, MD, head of the Virchow Clinic at Charite University Hospital, Berlin.
  • In women, drug–eluting stents are safe and effective compared with bare–metal stents, and the observed benefit was greatest with newer–generation devices, a large meta–analysis by Roxana Mehran, MD, of the Icahn School of Medicine at Mount Sinai in New York City showed.

Drug–drug interactions

  • A British study of 18 820 admissions revealed that 16% were due to drug–drug interactions (DDI). This resulted in a mortality of 2% to 3%, not to mention increased length of stay and cost.
  • A Swedish study of nine million people revealed that increased age and the use of five or more drugs were tightly correlated with increased risk of DDI.
  • Cardiologists should not use clarithromycin. The simvastatin and azithromycin combination leads to1.5 increase in simvastatin concentration, but with clarithromycin there is a yield of 10 times the concentration of simvastatin. It also increases digoxin levels.
  • Low–dose omeprazole did not affect clopidogrel metabolism but high dose did.
  • Genetic polymorphisms are at play, so listen to your patient.

(Dr C Funk–Brentano Paris)

cpr10 Mantra The CPR 10 Mantra is – "within 10 minutes of death, earlier the better; at least for the next 10 minutes, longer the better; compress the centre of the chest of the dead person continuously and effectively with a speed of 10×10 i.e. 100 per minute."

VIP’s on CPR 10 Mantra Video
Ringtone – CPR 10 Mantra Hindi

Ringtone – CPR 10 Mantra English

sprritual blog The empty mind is devil’s house

It is an old saying that "Khali dimag, shaitan ka ghar".

An empty mind means when you are doing nothing and Shaitan means negative thoughts. In terms of Vedic Sciences, negative thoughts mean absence of positive thoughts and they are often equated to darkness which is absence of light. Positive thoughts always need efforts and exertions while negative thoughts are spontaneous and without exertion.

It is recommended that one should think differently and positive otherwise there will be spontaneous appearance of negative thoughts.

Darkness is spontaneous and naturally present and to bring light one has to make efforts by switching on the light or the nature has to ask the Sun to come and give the light.

cardiology news

Going the Extra Mile

I was 20 and had just finished my first degree when I asked my father’s advice on how to approach the world of work. He had a long and distinguished career in the Indian Army and rose to become commander–in–chief of a million men. He was a soldier’s soldier and his men adored him. His manner was strict and firm, but he was very friendly. He appreciated and trusted people and gave then freedom.

"Come and see me in my office if you want to talk to me about work" he said. So I made an appointment with his ADC and went to see him. He had a huge office and I felt very small.

"You are starting out and you will be given a lot of tasks to fulfill" he said. "The first thing is always to do something to the best of your ability. Then the second time you do it, give it that little bit extra". What he was saying was: "Take the initiative; be innovative; be creative. Always go the extra mile."

News Around The Globe

  • Very few physicians mention sunscreen during patient visits, even when seeing patients with a history of skin cancer, according to a new study published online September 4 in JAMA Dermatology. In the study, there were no differences in sunscreen recommendation with respect to age or ethnicity; however, sunscreen was recommended more often for patients in their 70s and was recommended the least for children younger than 10 years.
  • China is facing an epidemic of diabetes and of diseases for which diabetes is a major risk factor, including ischemic heart disease, stroke, and chronic kidney disease, according to a massive study of nearly 100,000 Chinese adults reported in the September 4 issue of the Journal of the American Medical Association. Salient findings were: Prevalence of diabetes was 11.6%, two–thirds of diabetes cases were undiagnosed, only 25.8% of diabetics were receiving treatment, less than 40% of treated patients had adequate glycemic control and over half of Chinese adults were prediabetic.
  • New guidelines from the European Society of Cardiology and the European Association for the Study of Diabetes recommend that clinicians should use glycated hemoglobin (HbA1c) to diagnose diabetes. If a patient doesn’t have diabetes on the basis of an HbA1c reading, then he or she should be screened with an oral glucose tolerance test (OGTT). The new guidelines were presented by Lars Ryden, professor emeritus of the Karolinska Institute in Sweden and co–author Peter Grant, MD, of the University of Leeds in England at the ESC meeting in Amsterdam.
  • A third subtype of gastric adenocarcinoma that preferentially responds to 5–fluorouracil (5–FU) has been identified. It has been named the metabolic subtype. According to t Steve Rozen, PhD, director of the Centre for Computational Biology at the Duke–National University of Singapore (NUS) Graduate Medical School, their study has shown that there are actually 3 distinct molecular classifications that appear to be biologically and therapeutically meaningful
  • A polypill containing an aspirin, a statin and two antihypertensive agents greatly improved medication adherence compared with usual care, but the polypill patients achieved only modest, though significant lowering of systolic blood pressure and LDL cholesterol. Moreover, those adherent patients were no less likely to experience a serious adverse event such as myocardial infarction or stroke, according to results from the UMPIRE trial, which were published in the Sept. 4 issue of the Journal of the American Medical Association.

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Rabies News (Dr. A K Gupta)

What is the role of monoclonal antibodies in rabies?

Monoclonal antibodies against rabies virus have been widely used in the diagnosis and immunological analysis of rabies. Human monoclonal antibodies to rabies virus G protein are also expected to be used as a replacement for rabies immunoglobulin (RIG) in the post–exposure treatment of rabies. In 1978, Wiktor reported the preparation of rabies virus monoclonal antibodies. Since then, rabies virus monoclonal antibody (mAb) technology has been more and more widely used in basic research and diagnosis of rabies.

cardiology news
  • National door–to–balloon times have dropped significantly for patients with a ST–segment elevation myocardial infarction (STEMI), according to Daniel Menees, MD, of the University of Michigan in Ann Arbor, and colleagues. However, this decline has not translated into reduced in–hospital mortality or 30–day mortality suggesting that other strategies will be needed to cut the risk of death for patients with STEMI
  • The same heart–healthy diet that can prevent heart disease also might boost survival long–term after a heart attack. In an observational study reported online in JAMA Internal Medicine, the healthiest eaters were 24% less likely to die during the study period after initially surviving a myocardial infarction (MI) than those who had the worst diets. People who improved their diet the most after an MI also had a 29% lower overall and 40% lower cardiovascular mortality risk compared with those who changed the least.

Valvular Heart Disease News

Complications of infective endocarditis include cardiac sequelae (e.g., heart failure and perivalvular infection) and end-organ infection or infarction due to embolic events.

(Experts: Dr Ganesh K Mani, Dr Yugal Mishra, Dr Deepak Khurana, Dr Rajesh Kaushish, Dr K S Rathor, Dr Sandeep Singh and Dr KK Aggarwal)

cardiology news
  • Vagus nerve stimulation (VNS) may be considered for seizures in children, for seizures associated with Lennox–Gastaut syndrome (LGS), and for improving mood in adults with epilepsy, according to an evidence–based guideline update from the American Academy of Neurology (AAN) published online August 28 in Neurology.. The guidelines further recommend that children should be carefully monitored for site infection after VNS implantation.
  • A brief educational intervention for mothers of preterm infants significantly reduces symptoms of trauma and depression, according to a new study published online September 2 in Pediatrics. Change in the Davidson Trauma Scale (DTS), the scale used to assess symptoms of posttraumatic stress disorder was the primary outcome measure. There was a greater reduction in DTS scores among mothers in the intervention group vs mothers in the comparison group. There was also a comparatively greater reduction in symptoms of depression among mothers in the intervention group.
cardiology news

Faster chest compressions during CPR may not be better

According to a study published in the journal Resuscitation, performing CPR too quickly may be detrimental to a patient because the compressions may not be deep enough to achieve the desired effect.

When the individual performing CPR did so at a rate of more than 145 chest compressions each minute, the compressions only achieved a depth of less than four centimeters.

Compressions should be no less than five centimeters.

cardiology news

CMAAO India Conference will be held from September 12 to 14, 2013 at Hotel Shangri La, New Delhi

CMAAO represents Confederation of Medical Associations in Asian and Oceania. The theme for the conference on 12th and 13th will be "Be Human Stop Child Abuse" and on 14th will be "Lifestyle disorders".

cardiology news

Total CPR since 1st November 2012 – 62980 trained

CPR Classes 62980

Media advocacy through Print Media

sprritual blog Media Press Clipping Media Press Clipping Media Press Clipping
sprritual blog Media Press Clipping Media Press Clipping Media Press Clipping

29th August: Veer Arjun

Media advocacy through Web Media

When Constipation May be a Serious Problem 30th August


TB more dangerous than FLU 29th August


Guidelines about eating

Malnutrition and wrong dietary habits have been identified as major risk factors for ill health, including heart attacks. Most people living below the poverty line suffer from malnutrition due to lack of calories, proteins and vitamins in their food. In the affluent society, overeating or eating wrong food leads to overnutrition, a form of malnutrition leading to heart blockages.

In this context, the Heart Care Foundation of India has formulated guidelines about eating said Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal, President Heart Care Foundation of India and MTNL Perfect Health Mela. These include:

  • Eat only when you are hungry.
  • Do not eat for pleasure, social obligations or emotional satisfaction.
  • Eat at a slow pace.
  • Eat less; dinner less than lunch.
  • Take small mouthfuls each time, chew each morsel well, swallow it and only then take the next morsel.
  • Do not eat while watching television, driving a car or watching sports events. The mind is absorbed in these activities and one does not know what and how much one has eaten.
  • Do not talk while eating and never enter into heated arguments. The stomach has ears and can listen to the conversation. It will send signals accordingly to the mind and heart.
  • Plan and decide in advance what and how much you are going to eat.
  • Use low fat or skimmed mild dairy products. For cooking, use oils which are liquid at room temperature.
  • Do not take red meat, if you are a non–vegetarian. You may take poultry meat or fish.

About HCFI: The only National Not for profit NGO, on whose mega community health education events, Govt. of India has released two National commemorative stamps and one cancellation stamp, and who has conducted one to one training on" Hands only CPR" of 63000 people since 1st November 2012.

The CPR 10 Mantra is – "within 10 minutes of death, earlier the better; at least for the next 10 minutes, longer the better; compress the centre of the chest of the dead person continuously and effectively with a speed of 10×10 i.e. 100 per minute."

today emedipics

A CPR 10 Training Camp was organized by Heart Care Foundation of India to train the students of Modern School Noida on 14th August

press release

White rice linked to diabetes in Asians

today video of the dayDr KK Aggarwal on Costly Treatment

Dr KK Aggarwal on Sleeping Disorder

Dr KK Aggarwal on Doctors Day SAHARA SAMAY News

eMedi Quiz

Read this…………………

A male client is scheduled for a renal clearance test. Nurse Maureen should explain that this test is done to assess the kidneys’ ability to remove a substance from the plasma in:

a. 1 minute.
b. 30 minutes.
c. 1 hour.
d. 24 hours.

Yesterday’s Mind Teaser: Nurse Agnes is reviewing the report of a client’s routine urinalysis. Which value should the nurse consider abnormal?

a. Specific gravity of 1.03
b. Urine pH of 3.0
c. Absence of protein
d. Absence of glucose

Answer for yesterday’s Mind Teaser: b. Urine pH of 3.0

Correct answers received from: Dr Prakash Khalap, Dr. V.P. Thakral, Sadai V Appan, chandulal parmar, DrValluriRamarao, Narahari Kandakatla, daivadheenam, Dr Jainendra Upadhyay, Dr.K.V.Sarma, Dr.K.Raju, Muthumperumal Thirumalpillai, Dr.Chandresh Jardosh, DR.BITAAN SEN & DR.JAYASHREE SEN, DR AVTAR KRISHAN, Anil Bairaria, Dr B K Agarwal, Dr Kanta Jain, Dr. Parul Chopra Buttan

Answer for 4th September Mind Teaser: b. Weight loss.

Correct answers received from: Dr.Chandresh Jardosh, DR.BITAAN SEN & DR.JAYASHREE SEN, DR AVTAR KRISHAN, Anil Bairaria, Dr B K Agarwal, Dr Kanta Jain, Dr. Parul Chopra Buttan

Send your answer to ijcp12@gmail.com

medicolegal update

Click on the image to enlarge

medicolegal update

Customer: My keyboard is not working anymore.
Tech support: Are you sure it’s plugged into the computer?
Customer: No. I can’t get behind the computer.
Tech support: Pick up your keyboard and walk 10 paces back.
Customer: OK
Tech support: Did the keyboard come with you?
Customer: Yes
Tech support: That means the keyboard is not plugged in. Is there another keyboard?
Customer: Yes, there’s another one here. Ah...that one does work…

medicolegal update
medicolegal update

Click on the image to enlarge

medicolegal update

Situation: A patient with suspected pneumonia and normal x–ray died 12 hours after admission.
Reaction: Oh my God! Why were antibiotics not started?
Lesson: Make sure that all patients with suspected pneumonia are given antibiotic at the first suspicion as x–ray can be normal in the first 24 hours.

medicolegal update

Money is not the most important thing in the world. Love is. Fortunately, I love money. Jackie Mason

medicolegal update

Dr KK Aggarwal: Low BP may be normal By Dr K K Aggarwal http://bit.ly/16wknsh #Health

Dr Deepak Chopra: Those who make wise choices in life should wind up happier & more successful http://tinyurl.com/l6x3eo4

medicolegal update

Many happy returns of the day ! Prof M E Yeolekar, Mumbai.

Forthcoming Events

29thSeptember–Dil Ka Darbar at NDMC Convention Centre, CP New Delhi

20th Perfect Health Mela from 18th Oct to 22nd Oct at different locations

20th Perfect Health Mela from 23rd Oct to 27th Oct at Constitution Club of India

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medicolegal update

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